What is BMT?

BMT (Bone Marrow Transplantation) or as broadly known, HSCT(Haemopoietic Stem Cell Transplantation) is a modern branch of medicine that has now become the standard of care for many blood malignancies and other disease. The procedure requires chemotherapy and/or radiotherapy (i.e., ‘conditioning’) to be delivered to a patient in order to destroy a clone of abnormal or malignant blood cells. Following conditioning, a patient is rescued by infusion of cells which repopulate a new bone marrow – the haemopoietic stem cell. This treatment is followed by an intensive supportive care for several weeks whilst the new stem cells make their way to the bone marrow to grow platelets, red and white blood cells which are essential to lead a normal life.

There are two main types of HSCT, based on the source of the blood stem cell; (a) Autologous (self) transplants and (B) Allogeneic (donor) transplants.

Autologous stem cell transplant, performed on Multiple Myeloma, relapsed Lymphoma and auto-immune diseases, uses patient’s own bone marrow (autologous HSCT) or peripheral blood stem cells. This requires the collection of blood stem cells through the intricate procedure, ‘apheresis’, utilising the skills of clinicians, nursing and scientific staff. The cells are subsequently cryopreserved until required for the autologous HSCT.

Allogeneic stem cell transplants can be from a variety of sources such as siblings, matched unrelated donors (matched for 8/8 Human Leukocyte Antigens, hapoidentical transplants (where the match is from a family member who is only half matched, HLA 4/8) or cord blood stem cell transplants. Allogeneic stem cell transplant is generally used for acute leukaemia.